Myeloma Awareness Month

Dental and Oral Complications

Dental and Oral Complications

Many cancer patients are at high risk for dental and oral complications due to their cancer treatment or the side effects of their cancer treatment. The severity of side effects depends on the individual and on the cancer treatment itself. Before treatment begins, it is important for patients to understand the causes of oral complications and how to treat them in order to reduce symptoms and improve quality of life.

Treatments that May Cause Dental and Oral Complications

Chemotherapy. Most of the oral complications caused by chemotherapy are short term and typically resolve after treatment ends. Oral complications caused by chemotherapy include

Mouth sores (oral mucositis)

Bleeding in the mouth

Dry mouth (xerostomia)/salivary gland dysfunction.

Tooth decay and gum disease

Infection

Pain

Difficulty swallowing (dysphagia)

Changes in taste

Neurotoxicity

Changes in dental growth and development occur in children.

Malnutrition or dehydration

Radiation to the head and neck. Oral complications caused by radiation therapy include:

Bone-modifying drugs. Bisphosphonates are a class of drugs that prevent bone loss. Patients should understand that although bisphosphonates are effective, these drugs also carry risk to their dental health. Bisphosphonate treatment can cause a rare but serious side effect called “osteonecrosis of the jaw (ONJ).” ONJ causes part of the jaw bone to die, which can lead to pain, open sores and higher risk of tooth loss and infection. Patients should have a dental check-up before starting treatment with this class of drugs and address any dental problems before treatment begins. Doctors will stop the bisphosphonate treatment if ONJ occurs.

Before Cancer Treatment

Good dental hygiene, before and during cancer treatment, may help to either prevent or decrease the associated oral complications. Patients should learn about proper dental care so that they can lessen side effects and manage symptoms. The goal is to treat existing oral problems before treatment begins and to become educated about the potential risks, side effects and complications of therapy.

When treatment is not urgent, patients should visit a dentist at least four weeks before treatment starts. A pretreatment oral evaluation will identify problems such as cavities, fractured teeth, loose crowns or fillings, or gum disease. These problems should all be addressed in order to reduce the risk of complications.

During Cancer Treatment

To decrease the risk of complications such as cavities, mouth sores and infections during treatment, it is important to keep the mouth, teeth and gums clean.

Patients can take the following steps to help improve their oral health:

Brush teeth and gums two to three times a day.

Use a fluoride toothpaste with a mild taste—flavorings can irritate the mouth.

Gently floss once a day.

Every 2 hours, rinse the mouth with a solution of water, salt and baking soda to prevent soreness.

Use an antibacterial rinse two to four times a day to prevent gum disease.

Use a lip-care product to prevent your lips from drying and cracking.

Brush dentures every day, clean with a denture cleaner recommended by the dentist, and keep dentures moist when not being worn.

Pay attention to diet. Try to

Choose healthy foods that are mild, soft, and easy to chew and swallow.

Look in your mouth every day and note sores or other changes. Take steps to help prevent and treat a sore mouth.

Management of Complications

Call your doctor, nurse, or dentist if you notice oral complications. The patient and doctor or dentist should work together to manage symptoms and treat complications, either with medication or supportive care.

Financial Implications

Paying for dental care is a concern for many cancer patients. Not everyone can afford dental insurance, and dental benefits are not always an option. It is important that patients educate themselves about their medical and dental insurance coverage and its limitations before they begin cancer treatments.

Patients should share their financial concerns with their medical and dental teams and find out if there are any financial resources available to them. See the fact sheet, Dental and Oral Complications of Cancer Treatment Facts, for a list of organizations that may be able to help.

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The Leukemia & Lymphoma Society (LLS) is the world's largest voluntary health agency dedicated to blood cancer. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. LLS funds lifesaving blood cancer research around the world and provides free information and support services.

The Leukemia & Lymphoma Society is a 501(c)(3) organization, and all monetary donations are tax deductible to the fullest extent allowed by tax laws. Please check with your financial advisor if you have more questions.